The cost of health insurance for Marylanders has tripled over the past nine years, growing at a rate equal to the national average despite a much-praised regulatory system to hold down hospital rates.
That was the charge in a report released yesterday by a hospital workers union that is negotiating new contracts with five area hospitals, with health insurance costs for its members a major issue.
District 1199E-DC, Service Employees International Union, also announced that it has reached tentative agreement on new three-year contracts with three hospitals covering some 2,150 workers.
The similar pacts call for yearly wage increases of nearly 5 percent but also cut employee costs for health care coverage.
"This is the best contract we've gotten in 10 years, but we still haven't made up the losses from inflation over that time," said Robert Moore, District 1199E-DC president.
Members will vote on contracts with Johns Hopkins, Liberty and Maryland General hospitals by this weekend, while negotiations continue with Sinai and Greater Baltimore Medical Center, covering 830 employees, he said.
The SEIU called for legislative reform of the state's health care system, including regulation of doctor fees and other services and facilities now outside the rate-setting authority of Maryland's 20-year-old Health Services Cost Review Commission.
The commission's task is to set reasonable hospital charges. But the labor union charged that these institutions have increasingly shifted their assets into non-regulated activities, such as ambulatory patient centers and physician offices, that continue to drive up the overall cost of health care for Marylanders.
The SEIU also claimed that average wages for the lower-paid hospital workers have declined 12 percent over the past decade, adjusted for inflation.
"In many cases, our members suffer with poverty-level wages and inadequate health care coverage themselves," Mr. Moore said. "We are subsidizing the cost of health care for other people as we fall further behind in wages."
A nurse's aide in Baltimore starts at $11,000 a year, while the federal poverty income for a family of four is $12,700, the report stated.
Maryland hospitals have averaged 5 percent annual increases for labor costs in the rates set by the state commission since 1980, the union said, but they have not passed on these added revenues in pay to their orderlies, nursing assistants, clerks and maintenance workers.
Instead, said union staffer Sandy Polaski, "you can see these increases in the bond prospectuses of the hospitals" for building unregulated facilities.
Hospital workers have also been hit hard by heavy out-of-pocket health care expenses of their own, the union said.
A hospital worker earning $15,000 a year, or $7.21 an hour, an average wage in Baltimore institutions, has to pay as much as $851 for family health insurance premiums in addition to meeting steep co-payments and paying for non-covered services, Mr. Moore said.
"We are not just the people who work in these hospitals. We are also consumers of health care services like other people," said Mr. Moore, whose union has called two strikes in 10 years over health coverage.
The state legislature declined this year to approve a study of hospital work force issues, "so we've come up with our own report," Mr. Moore said.
"A legislative remedy is needed," said Ms. Polaski. "The state cannot afford not to plug these loopholes." But Mr. Moore admitted that no legislators have yet stepped forward to lead the charge for this type of reform.